Fentanyl in Cocaine: How Common Is It? (& How to Tell)

Medically Reviewed

In 2018, the U.S. Drug Enforcement Administration (DEA) announced that cocaine across the state of Florida was contaminated with fentanyl and its analogs. Fentanyl is a potent opioid that’s 100 times more powerful than morphine. The authorities also found carfentanil, which is similar but more powerful, around 100,000 times more powerful than morphine. They tested seized cocaine and found 180 different instancesof fentanyl contamination.

People taking fentanyl without realizing it may take a dangerously high dose, thinking it’s a standard dose of cocaine. According to the DEA, this opioid contamination has contributed to cocaine-related deaths. In 2016, Florida saw 36 cocaine-related deaths each month, and 84 of those involved carfentanil.

But how widespread is this deadly combination?

The DEA released a similar report in Pennsylvania. In New York City, 37 percent of cocaine-related deaths also involved fentanyl. According to the National Institute on Drug Abuse (NIDA), 19,000 of the 42,000 overdose deaths in 2016 involved fentanyl, which means this powerful synthetic opioid is partially to blame for nearly half of the nation’s overdose epidemic. Fentanyl can be injected, snorted, smoked, or taken orally. It can also be blended with other drugs like cocaine easily.

Why is Fentanyl Dangerous?

Fentanyl is a powerful synthetic opioid that’s used in medical settings all the time. However, illicit fentanyl has led to overdoses and fatalities all over the country. What makes it so dangerous? For one, fentanyl is just more potent than most drugs you might encounter on the street. A lethal dose for the average person is about 2 to 3milligrams, which is about the weight of a single snowflake.

In medical settings, professionals have the expertise and equipment to effectively create medications with a small enough amount to be helpful without being dangerous. Illicit drug dealers may not have the expertise, ability, or desire to painstakingly create drugs with a safe amount of fentanyl. It may be included to increase the potency of heroin or other drugs to make it seem like the drug is higher quality. But even a small amount of the drug can be dangerous.

Regular heroin users may be able to take more fentanyl without experiencing a fatal overdose. But if heroin contains just 0.7 percent fentanyl, it is likely to be fatal. At the same time, cocaine users who don’t use opioids will not have a tolerance to fentanyl and are more susceptible to harm.

Like other opioids, fentanyl depresses the central nervous system and causes a feeling of euphoria, sedation, and fatigue. In high doses, it can cause your nervous system to slow down to a dangerous degree. More specifically, your breathing will slow to the point where you may suffer oxygen deprivation, brain damage, coma, or death.

A drug called naloxone is used to reverse opioid overdoses and can save the lives of people who encounter fentanyl. However, fentanyl is so powerful that it may require multiple doses of the medication, and it needs to be administered quickly.

How is Illicit Fentanyl Distributed?

Fentanyl has been found in many forms and in several substances, including heroin, cocaine, meth, and prescription opioids. Illicit fentanyl is made in clandestine laboratories and sold on the black market. The recent influx of fentanyl trafficking can be traced to transnational criminal organizations. The drug is sold in powders, blotter paper, eye droppers, nasal sprays, and pills. Pressed pills can look like legitimate prescription pills, including logos.

Fentanyl can make its way into cocaine to produce the same effects a “speedballing,” which is a term used to describe intentionally mixing heroin and cocaine for a unique high. However, mixing opioids and powerful stimulants can cause symptoms like cardiac arrhythmia and other heart-related complications.

Fentanyl is cheap, easy to make, and easy to transport in small but cost-effective packaging. It can be added to otherwise adulterated drugs that may be noticeably weaker than what a drug dealer’s clients are used to. Fentanyl adds extra potency to the weekend substance. Heroin that is diluted with inert substances can be made to feel incredibly pure and powerful. Weakened cocaine can be sold as a speedball.

Can You Tell Fentanyl Apart From Cocaine?

If fentanyl-laced cocaine is becoming more and more of an issue, is it possible to tell the difference before you use? Unfortunately, it’s virtually impossible to tell the difference between typical illicit cocaine and fentanyl-laced cocaine.

Fentanyl in powder form is a white substance that’s nearly identical to powdered cocaine. Other adulterants might change the color of either substance slightly, but other than that, they might look the same. However, even if you could tell the difference, it only takes less than a gram to be active, and 2 grams can be deadly.

Even a light dose of cocaine at 10 milligrams is like a haystack than 2 grams of fentanyl could easily get lost in. Illicit drug use is dangerous on its own, but fentanyl has made it even more dangerous with no real way to get around it safely. Some drug-testing kits can be used to see if your cocaine has fentanyl in it before you use it. Harm reduction services may sell these kits to help people avoid dangerous drug overdoses. However, any kit that doesn’t specifically test for fentanyl shouldn’t be trusted, and not all at-home drug testing kits are foolproof.

How can Cocaine and Opioid Addiction Be Treated?

If you’ve been using cocaine or opioids, and you’re worried that you might have a substance use disorder, it’s important to seek addiction treatment as soon as possible. Each time you use an illicit drug, you risk dangerous consequences. Illicit substances are unpredictable; it’s difficult to know if what you are getting is a safe dose of the drug you know. However, even if you have a severe substance use disorder, it can be treated.

Through medical detox and addiction treatment, you can achieve sobriety, even if you’ve tried and relapsed before. Addiction treatment is designed to provide a personalized treatment plan to individuals that have a substance use disorder. However, treatment also needs to address issues that are directly and indirectly related to drug use, including medical, psychological, social, financial, and legal issues.

Addiction treatment also involves several types of therapies, including individual, family, and group therapy. It may also involve a variety of behavioral therapies, including cognitive behavioral therapy, which is used to learn to identify and cope with triggers.

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